Naderi Nasim, Chenaghlou Maryam, Mirtajaddini Marzieh, Norouzi Zeinab, Mohammadi Nasibeh, Amin Ahmad, Taghavi Sepideh, Pasha Hamidreza, Golpira Reza
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran,Iran.
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
J Cardiovasc Thorac Res. 2022;14(1):11-17. doi: 10.34172/jcvtr.2022.08. Epub 2022 Mar 12.
Heart failure(HF) related hospitalization constitutes a significant proportion of healthcare cost. Unchanging rates of readmission during recent years, shows the importance of addressing this problem. Patients admitted with heart failure diagnosis in our institution during April 2018to August 2018 were selected. Clinical, para-clinical and imaging data were recorded. All included patients were followed up for 6 months. The primary endpoints of the study were prevalence of early readmission and the predictors of that. Secondary end points were in-hospital and 6-month post-discharge mortality rate and late readmission rate. After excluding 94 patients due to missing data, 428 patients were selected. Mean age of patients was 58.5 years (±17.4) and 61% of patients were male. During follow-up, 99patients (24%) were readmitted. Early re-admission (30-day) occurred in 27 of the patients(6.6%). The predictors of readmission were older age ( = 0.006), lower LVEF ( <0.0001), higher body weight ( = 0.01), ICD/CRT implantation ( = 0.001), Lower sodium ( = 0.01), higher Pro-BNP( = 0.01), Higher WBC count ( = 0.01) and higher BUN level ( = 0.02). Independent predictors of early readmission were history of device implantation ( = 0.007), lower LVEF ( = 0.016), QRS duration more than 120 ms ( = 0.037), higher levels of BUN ( = 0.008), higher levels of Pro-BNP( = 0.037) and higher levels of uric acid ( = 0.035). Secondary end points including in-hospital and 6-month post-discharge mortality occurred in 11% and 14.4% of patients respectively. Lower age of our heart failure patients and high prevalence of ischemic cardiomyopathy, necessitate focusing on more preventable factors related to heart failure.
心力衰竭（HF）相关住院费用在医疗成本中占很大比例。近年来再入院率保持不变，这表明解决这一问题的重要性。选取了2018年4月至2018年8月期间在我院因心力衰竭诊断入院的患者。记录临床、辅助检查和影像学数据。所有纳入患者均随访6个月。该研究的主要终点是早期再入院率及其预测因素。次要终点是住院期间和出院后6个月的死亡率以及晚期再入院率。在排除94例因数据缺失的患者后，选取了428例患者。患者的平均年龄为58.5岁（±17.4），61%的患者为男性。随访期间，99例患者（24%）再次入院。27例患者（6.6%）发生早期再入院（30天内）。再入院的预测因素为年龄较大（P = 0.006）、左心室射血分数较低（P <0.0001）、体重较高（P = 0.01）、植入式心律转复除颤器/心脏再同步化治疗（ICD/CRT）植入（P = 0.001）、血钠较低（P = 0.01）、B型利钠肽原（Pro-BNP）较高（P = 0.01）、白细胞计数较高（P = 0.01）和血尿素氮（BUN）水平较高（P = 0.02）。早期再入院的独立预测因素为器械植入史（P = 0.007）、左心室射血分数较低（P = 0.016）、QRS时限超过120毫秒（P = 0.037）、BUN水平较高（P = 0.008）、Pro-BNP水平较高（P = 0.037）和尿酸水平较高（P = 0.035）。次要终点包括住院期间和出院后6个月的死亡率，分别发生在11%和14.4%的患者中。我们心力衰竭患者年龄较低且缺血性心肌病患病率较高，因此有必要关注更多与心力衰竭相关的可预防因素。
